糖皮质激素联合人工肝血浆滤过透析模式治疗乙肝所致肝衰竭的疗效及安全性

Efficacy and Safety of Glucocorticoid Combined with Artificial Liver Plasma Filtration Dialysis Model in the Treatment of Liver Failure Caused by Hepatitis B

目的探讨糖皮质激素联合人工肝血浆滤过透析模式治疗乙肝所致肝衰竭的临床效果。方法选取2020年6月至2023年6月赣州市第五人民医院收治的84例乙肝所致肝衰竭患者,按随机数字表法分为两组,各42例。对照组予以人工肝血浆滤过透析模式治疗,观察组在对照组基础上加用糖皮质激素治疗,2周后比较两组临床疗效,肝功能指标[天冬氨酸氨基转移酶(AST)、丙氨酸转氨酶(ALT)、总胆红素(TBiL)],凝血功能[凝血酶原时间(PT)、凝血酶原活动度(PTA)],免疫功能[CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)]及安全性。结果观察组总有效率高于对照组,差异有统计学意义(P<0.05)。治疗后,观察组AST、ALT、TBiL较对照组低,差异有统计学意义(P<0.05);观察组PT短于对照组,PTA高于对照组,差异有统计学意义(P<0.05);观察组CD4^(+)、CD4^(+)/CD8^(+)高于对照组,CD8^(+)低于对照组,差异有统计学意义(P<0.05)。两组安全性相比,差异无统计学意义(P>0.05)。结论糖皮质激素联合人工肝血浆滤过透析模式可提高乙肝所致肝衰竭治疗效果,减轻患者肝功能损害,纠正凝血及免疫紊乱,安全可靠。

Objective To investigate the clinical effect of glucocorticoid combined with artificial liver plasma filtration dialysis model in the treatment of liver failure caused by hepatitis B.Methods 84 patients with hepatitis B induced liver failure admitted to The Fifth People's Hospital of Ganzhou from June 2020 to June 2023 were divided into 2 groups according to random number table method,with 42 cases in each group.The control group was treated with artificial liver plasma filtration dialysis model,and the observation group was treated with glucocorticoid based on the control group.After 2 weeks,the clinical efficacy,liver function indexes(AST,ALT,TBiL),coagulation function(PT,PTA),immune function(CD4^(+),CD8^(+),CD4^(+)/CD8^(+))and safety of the two groups were compared.Results The total effective rate of the observation group was higher than that of the control group,the difference was statistically significant(P<0.05).After treatment,the AST,ALT and TBiL in the observation group were lower than those in the control group,and the difference was statistically significant(P<0.05);PT in observation group was shorter than that in control group,PTA was higher,and the difference was statistically significant(P<0.05);CD4^(+)and CD4^(+)/CD8^(+)in observation group were higher than control group,and CD8^(+)was lower than control group,the difference was statistically significant(P<0.05).There was no significant difference in safety between the two groups(P>0.05).Conclusion Glucocorticoid combined with artificial liver plasma filtration dialysis model can improve the therapeutic effect of hepatitis B induced liver failure model,reduce liver function damage,correct coagulation and immune disorders,and is safe and reliable.